Accommodations, Public Access, Information, and Design Consulting by Dolle
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Prior to my work in in cognitive accessibility and the
cognitive neurosciences, I spent 17 years working as a nuclear medicine technologist,
medical consultant, and a small business owner. During those years, while
working with some 50-60 hospitals & imaging centers, I came across
many different types of imaging instruments, some of which were archaic
and/or very poorly designed. Yet, I was still able to adapt and extract valuable
diagnostic information from these instruments for my patients, including, instruments like the
old analog thyroid scanner pictured here.
Then in 1992, I suffered a brain injury during an automobile accident, and was
forced to undergo surgery for placement of a CNS shunt for hydrocephalus. I then had to adapt to a
complex and often confusing world, that is not well adapted for persons with
cognitive disabilities. Fortunately, I
was familiar with hydrocephalus & CNS shunts from my nuclear medicine work, and
post injury I became very involved in testing & diagnostics, and user instructions and labeling
of CNS shunt devices. These efforts led me to author a critical petition
in 1996 to the Food & Drug Administration on problems with anti-siphon
shunts, much of which centered on problems with their labeling and user
instructions. As I would learn, few neurosurgeons in the
field then really understood CNS shunts and how each was to be used. For many
years (even as late as 2010), neurosurgeons often said, "All shunts are really the
same." And of course, I cited this in my petition and in other efforts, and
described how many of the CNS shunt user instructions then by shunt manufacturers
were like something out of a 1960s medical text
book. And FDA agreed! I bring this up here, because it speaks to cognitive
accessibility & usability of highly complex CNS shunt devices by
neurosurgeons. My point is, whether we're speaking of CNS
shunt devices, nuclear medicine instruments, consumer devices, or instructions
places, cognitive accessibility & usability still applies. The primary difference
then being a different user audience, and different threshold of background
knowledge. These same principles apply to teaching, where
teachers must make their content understandable or accessible to a wide
range of students.
My first cognitive accessible artificial intelligence, or AI design, came in 1996-97
with the design of the DiaCeph Test for home monitoring of hydrocephalus.
The challenge was in creating software for a PDA with sufficient user
instructions so that its scientific methods would be understandable by both
patients/families, and neurosurgeons. As my work with AI
progressed, I began to explore its uses with the new Palm Pilot PDA. And I then
began to adapt cognitive uses to mobile phones, digital recorders, digital cameras, and
then smart phones and apps today.
By 2002, I had been in contact with accessibility staff at Hewlett Packard, the
Trace Center in Wisconsin, the Coleman Institute in Colorado, Microsoft, and others.
However, and that time, most all of the groups were focused on lower
functioning users, needs, and solutions. Without any support for the
AI high functioning products I wanted to produce, I was forced to move on to other things.
Over the following few years,
I provided some neurosciences consulting, expert witness work, and brought
a product's liability failure to warn case against manufacturers of two very
popular & opposing bathroom cleaning products. I had inadvertently
mixed the two in my home and ended up in the hospital with chemical pneumonitis
in 2001. I felt bringing this
case would be a true test of my skills in user instructions, science, and public
safety. At the
time, I was not
too familiar with bathroom cleaners, but I
knew I'd pick it up. And law is in my genes! The case went on for 10 months. In the end, I prevailed
defendants' Motions for Summary Judgment. I bring this up, because today I find remarkable similarities
between product's liability failure to warn and
cognitive accessibility - rarely brought in civil suits in Superior Court. Yes, the threshold
of information is different. But manufacturers still must provide adequate user instructions,
which for persons with cognitive disabilities, must be very specific. Then in 2004, I became
involved in drumming, or drum circles, and I began to explore its use in persons
processing disorders (SPDs), and other disorders of the brain.
I stayed abreast of developments in assistive (cognitive) technologies. And
in 2008, this led to cognitive accessibility of mobile smart phones and led me to Clayton Lewis at the U. of Colorado.
Here, I shared a vision with him for a special "Cognitive Accessibility" category of smart
phones for users with special cognitive needs. It seemed like a great idea. But,
sadly I would learn the
Finally, in November 2013, I secured the domain, CognitiveAccessibility.org
and began to write discussions on LinkedIn about what I term our
"Cognitive Accessibility Crisis." Some of
my writings also appear on my
Dolle Communications Blog, and are linked at bottom.
I see a tremendous need to modernize our "accessibility standards" for persons with
cognitive disabilities. And I propose the following Three Pronged Platform:
Three Pronged Cognitive Accessibility Platform for Persons with Cognitive Disabilities
ONE: REASONABLE ACCOMMODATIONS FOR SENSORY PROCESSING
Reasonable protection & accommodation
from unhealthful sounds, lights, scents, and motion/vibration in public places,
and in public broadcasts. This would extend to the volume in TV commercials
already established by the 2012 CALM Act. In addition, I am calling for the
development of an audio "Sound Sensory Processing Standard, for use in TV &
radio commercials, movies, television programs, and the like, to establish a
clear audio standard on what is considered unhealthful mixing and manipulation
of audio for persons with sensory processing disorders, or SPDs. At the present
time, the only standard is the Decibel Scale, which only measures loudness, and
not the viability of audio broadcasts for processing by listeners.
TWO: COGNITIVE ACCESSIBILITY OF WEB SITES,
MOBILE PHONES, PRODUCT LABELS, PUBLIC PLACES, STORE SHELVES
accommodations and new
cognitive accessibility standards for access/use of web sites, mobile phones,
consumer and household
instruments, consumer products, user instructions, and their warnings, and
labeling. These should meet new all new standards for user access, and
usability, and lay out clear consequences for non-compliance.
THREE: PUBLIC ACCESS TO ASSISTIVE TECHNOLOGY FOR
PERSONS WITH COGNITIVE DISABILITY
A higher threshold of reliability,
usability, and customer support for (established) assistive cognitive
technologies, which persons with special cognitive needs and cognitive
disabilities may use as an assistive aid for their cognitive disability. Over
the last 5 years, many users with special cognitive needs have come to rely upon
mobile phones, smart phones, PDA assistants, tablet computers, and accessory
as cognitive aids. But, manufacturers and service providers too often
treat the devices and user needs as toys, and "let the buyer beware" when it
comes to updates, customer service, and acceptable levels of reliability. For
users with special cognitive needs, today's level of tech support and
reliability for these device is often unacceptable. On mere contract law alone,
many manufacturers are in breach of user warranties. For a user with cognitive
needs, the experience and failures can amount to a long horrible nightmare.
U.S. and much of the world, in my view, has very outdated beliefs about brain
disability, brain health, and cognitive accessibility. I
hope to publish a new web site
www.CognitiveAccessibility.org to write about
the issues, brain science, and real design solutions. I hope to cover cognitive
accessible designs for websites, product labels, store displays, and
access/usability standards for public places, with consideration to the above
Cognitive Accessibility Platform.
Because of my experiences in living with cognitive
disability as a result of hydrocephalus and
numerous shunt malfunctions and surgeries over 22 years, I feel I bring a unique perspective and understanding to this
debate. As of 2014, I've
undergone a total of 12 shunt revisions, and have used my own ingenuity to help direct
many of these surgeries, and help others
around the world.
More recently while I was at an area Target store, I came
upon & photographed some 50-55
different makes of
toothpaste (photo, top left) on Target store shelves. I believe their offering
50-55 makes of toothpaste poses significant cognitive challenges to the many
consumers with special cognitive needs. The confusing display creates
unnecessary cognitive barriers, and is in need of substantial redesign both of
its packaging, and store shelf display.
These type of product labeling barriers can also extend to web sites, mobile apps, printed materials,
instructions on store shelves, and directions in public
places. There are countless examples of
problematic cognitive designs today that need to be modernized.
Through my wider efforts in the the cognitive neurosciences, I've been involved in learning,
sensory processing disorder, cognitive assistive technologies, music therapy & drumming,
and mHealth apps and diagnostics to improve brain health. Cognitive accessibility is the
latest prong in these efforts.
In 2014, I filed a request/complaint to the
Internet Association [of things] as to improving the cognitive accessibility
on cognitive accessibility
of web sites.
SEE also my posts on LinkedIn and my blog:
Below, I list other supporting web pages with
regards to cognitive
accessibility and the cognitive neurosciences.
-Stephen Dolle, neuroscientist
Our other Cognitive Neurosciences Web Content:
Sensory Processing Disorders Study
Sensory Processing Disorders
and Wellness Drumming
Drumming for Football
For more information,